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Amblyopia, Strabismus Outcome Measures Fall Short

Researchers need to identify a superior reporting tool, a new study finds.

Although researchers and clinicians alike know amblyopia and strabismus can negatively affect patients’ quality of life (QoL), the current methods for determining the exact impact are sorely lacking, according to a new report in Clinical and Experimental Optometry.

After identifying and analyzing 32 amblyopia- and/or strabismus-specific patient-reported outcome measures (PROMs), researchers from Australia noticed only four have been subjected to modern psychometric tests. Of the 12 amblyopia-specific questionnaires, two—the Amblyopia Survey and the Socio-Professional Integration Questionnaire—measured the impact of the condition itself, while the other 10 focused on the impact of treatment with patching or atropine. Of the 16 strabismus-specific tools, six measure the impact of strabismus on QoL, eight assess patients’ psychosocial well-being post-strabismus surgery and the remaining tools focus on patient expectations and treatment concerns.

For clinicians looking for a tool to help guide their decision-making for adult patients considering strabismic surgery, the PROMs show even less promise: just one adult strabismus questionnaire demonstrated good measurement properties.

“All instruments have gaps in their content and failed to address QoL comprehensively,” the study said. “Lack of adequate content could be a potential reason why amblyopia and strabismus-speciﬁc instruments are often used in conjunction with other measures, particularly one of the psychological and behavioral inventories.”

Now that the researchers have identified such a gap, their next step is “developing amblyopia and strabismus-speciﬁc item banks measuring a series of QoL domains using robust research methods.”